• Zong-Yang Wu, Yong-Jian Zhu, Lei Chu, Chun-Yuan Cheng, Chien-Min Chen, and Hsu Hui-Ting.
• Department of Neurosurgery, Changhua Christian Hospital, Changhua City, Taiwan.
• World Neurosurg. 2017 Feb 1; 98: 883.e13-883.e20.

BackgroundThe incidence of spinal epidural hematoma (SEH) is estimated to be 1 per 1,000,000 patients per year; SEH can be classified as idiopathic, spontaneous, and secondary. The cause of spontaneous SEH is uncertain but it may be associated with minor trauma. SEH can compress surrounding structures, shown by clinical symptoms and signs that affect the spinal cord or nerve roots. Surgical treatment may be considered if medical treatment fails.Case DescriptionA 26-year-old man presented with lower back pain and significant radicular symptoms on the left side for a week. He denied previous lumbar trauma or the use of anticoagulation drugs. We used the full-endoscopic transforaminal approach (extraforaminal technique) to remove the SEH under local anesthesia. The patient was discharged home 2 days after surgery and the radicular pain disappeared completely. Three months later, follow-up magnetic resonance imaging showed that the dark-brown lesion had been totally removed.ConclusionsSpontaneous SEHs are uncommon. Although lumbar laminectomy is the mainstream treatment in those with neurologic deficits caused by epidural hematomas, the percutaneous full-endoscopic transforaminal approach may be an option for certain SEHs.Copyright © 2016 Elsevier Inc. All rights reserved.

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